双侧额颞平衡改良大骨瓣减压术治疗大面积脑梗死的疗效  

Curative effect of modified bilateral frontal-temporal large decompressive craniectomy symmetrically in the treatment of the massive cerebral infarction

作　　者：张新平[1] 徐庆余 卢鹏[1] 揭伟[1] 

机构地区：[1]四川省科学城医院神经外科,绵阳621000

出　　处：《中国实用神经疾病杂志》2016年第7期2-4,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的分析双侧额颞平衡改良大骨瓣减压术对大面积脑梗死的疗效。方法选择我院81例大面积脑梗死患者。按治疗方法不同分为对照组(n=41)及观察组(n=40),分别实施常规去骨瓣减压术及双侧额颞平衡改良大骨瓣减压术。比较2组GCS评分、昏迷分级、脑梗死灶变化、中线结构变化及预后优良率。结果术后3d、7d及14d,观察组GCS评分分别为(4.72±1.16)分、(7.95±1.74)分及(10.24±2.05)分,均显著高于对照组(4.15±1.23)分、(5.83±1.37)分及(6.45±1.43)分(P<0.05)。术后14d,观察组轻度昏迷及中度昏迷百分比分别为24.39%、41.46%,均显著高于对照组的5.00%、12.50%(P<0.01)。此外,术后3d、7d及14d,观察组梗死灶范围更小,中线位移更小(P<0.05)。随访发现,观察组预后优良率56.10%,显著高于对照组的27.50%(P<0.01)。结论双侧额颞平衡改良大骨瓣减压术治疗大面积脑梗死具有临床疗效好、预后佳等优点。Objective To evaluate the curative effects of modified bilateral frontal-temporal large decompressive craniecto- my symmetrically in the treatment of massive cerebral infarction. Methods Eighty-one patients with massive cerebral infarction in our hospital were included in the study, which were divided into two groups according to different methods. The observation group was treated by modified bilateral frontal-temporal large decompressive eraniectomy symmetrically compared to control group with conventional treatment. The GCS score, coma grade, cerebral infarcts, midline structure changes and the progno- sis were compared between two groups. Results The GCS scores of observation group were 4.72±1.16, 7.95 ± 1.74 and 10.24 ±2.05 at the 3rd, 6th, 9th, 12th, 15th day after operation, compared to 4.15±1.23, 5.83±1.37 and 6.45±1.43, respectively in control group, there were significant differences between the two groups （P〈0.05）. The mild and severe coma in observation group was 24.39% and 24. 390//oo respectively 14 days after postoperative, compared to 5. 000/6o and 12.50% in con- trol group. There were significant differences between the two groups （P〈0.01）. Compared to control group, the middle line displacement and infarcts range in observation group were slighter at 3rd, 7th and 14th day after postoperative, there was a significant difference between the two groups （P〈0.05）. The rate of good prognosis in observation group was 56.10%, compared to 27.50 % in control group （P〈0.01）. Conclusion Modified bilateral frontal-temporal large deeompressive craniectomy symmetrically has a good clinical effect in treatment of massive cerebral infarction, it is worth of promoting.

关 键 词：双侧额颞平衡改良大骨瓣减压术 大面积脑梗死 

分 类 号：R743.33[医药卫生—神经病学与精神病学]